American consumerism is a force to be reckoned with. Turn a few hundred million of the world's most sophisticated shoppers loose on an industry, and watch companies scramble after their business. In realms from washing machines to stock trades, quality goes up and price comes down as companies look for an edge over the next guy to win customer dollars.

Not in health care. Congress has overhauled the industry, but the revolution has largely been about increasing access to health care, not simplifying it. We are left with the same opaque system of perverse incentives--paying providers for more tests and procedures,...